Perception of neighborhood disorder and health service usage in a Canadian sample

Background: Neighborhood environment, both actual and perceived, is associated with health outcomes; however, much of this research has relied on self-reports of these outcomes. Purpose: The association between both perception of neighborhood disorder and neighborhood poverty (as measured by postal code socioeconomic status) was examined in the prediction of health service usage. Method: Participants in a longitudinal project were contacted in mid-adulthood regarding their perception of neighborhood disorder. Their census tract data and medical records were drawn from government databases. Results: Higher perceived neighborhood disorder was significantly associated with higher levels of total health services usage, lifestyle illnesses, specialist visits, and emergency room visits, even when neighborhood poverty and individual-level variables were controlled for. Neighborhood poverty was only significantly associated with fewer total hospitalizations. Conclusions: Higher perceived neighborhood disorder was associated with higher rates of health service usage, suggesting further investigation into the mechanisms by which perceptions of the environment influences health outcomes.